Passed-over med school grad learns life lesson, gets 2nd chance

Nick Frame waited a whole year for March 21, also known in the medical field as "Match Day."

At Detroit's MGM Grand Hotel & Casino, with about 269 other graduates of Wayne State School of Medicine, Frame found out he had matched with Mercy Health St. Mary's Hospital in Grand Rapids as a first-year medical resident in family medicine. He starts work July 1.

"I was excited, ecstatic, really happy," said Frame, 26, who decided his senior year at Eisenhower High School in Shelby Township that he wanted to become a doctor.

"I did want emergency medicine, but I think family medicine is a better fit for my personality as a whole," he said. "After residency, I can still go out and do emergency medicine."

As happy as Frame is now, it was a different emotion he experienced a year ago on Match Day.

On March 17, 2013, Frame's name wasn't called for a residency slot. He joined more than 1,500 other newly graduated medical students nationwide — and one other Wayne State student — with college debt of more than $200,000 who weren't selected by a teaching hospital.

"I was stunned, absolutely," he said. "I can't even remember the specifics of that. I had no idea what to do."

Frame said over the next several weeks he went through the motions to apply for the thousand or so unfilled residency slots nationally during the so-called "Scramble."

"There was one open ER spot. I applied to that. Some surgery, preliminary and family medicine slots," he said.

But Frame said he didn't put a lot of effort into it and didn't match in the Scramble, either. He was disappointed he didn't find a position along with 98.5 percent of his classmates at Wayne State who did match with a residency program.

Frame said given all the talk the past few years about the need for more physicians to care for an additional 30 million insured patients under the Patient Protection and Affordable Care Act, it didn't make sense to prevent more than 1,000 well-educated U.S. trained doctors each year from practicing medicine in hospital residency programs.

"I tried not to think about what else I would do for a career," he said. With $250,000 in medical school debt, Frame planned on paying down his debt with his post-residency salary and by practicing in an underserved medical area with various loan forgiveness programs from hospitals or government programs.

Physician supply priorities

Despite studies that show the U.S. will face a shortage of about 130,000 doctors by 2025, the U.S. has an artificial cap on the number of doctors accepted into hospital residency training programs.

While medical students are awarded medical degrees or osteopathic degrees, the M.D. or D.O. monikers, when they graduate, they can only be licensed by state medical boards as professional physicians after completing a residency program.

To become a practicing physician, more than 40,000 medical school graduates each year compete for nearly 30,000 first and second-year residency slots.

This year, 29,671 graduates matched into one of 9,600 accredited residency programs, including 16,400 graduates of U.S. schools and 9,287 graduates of international schools, according to the National Residency Matching Program.

Over the past 18 years, graduate medical education funding, which is primarily paid for by Medicare, has been frozen. However, teaching hospitals have increased the number of funded residency slots by about 12 percent since 1996 to about 110,000 residents from 98,000 by using their own funding sources.

In recent years, talk has surfaced about legislation to increase residency slots by as many as 15,000. But how to pay for additional doctors without raising the deficit or cutting other programs has stymied such efforts.

Dr. Frame makes a new plan

After the initial shock of not matching, Frame's dream of being a doctor slowly returned after some soul-searching and discussing his situation with his father, Phil Frame, and a number of physician mentors.

During the past year, with the help of James Meza, M.D., Margit Chadwell, M.D., Frame kept his hand on medicine by volunteering at the Robert R. Frank Student Run Free Clinic in Detroit.

"The advice I received was stay clinically active this year and apply next year. Another goal I decided to accomplish was to get back to what drew me to medicine in the first place, namely the free clinic," Frame said.

At the clinic, Frame said he met Chadwell, one of the physicians in charge. She created the position of post-graduate clinical director for Frame. While a volunteer, Frame said he worked 25 to 30 hours per week.

"I worked closely with Dr. Chadwell, the executive board and a group of students," he said. "I did a little of everything. I saw patients, filled in the gaps where needed. I ran chart reviews with students where we looked at patient needs one week before their visit so we could come up with a game plan when they came in."

Frame said that in the past year, he has learned more about delivering patient care and the intricacies of administering a clinic.

He also met Meza, whom Frame described as a person who not only gave him invaluable medical career advice but also help with general life issues.

"We kind of bonded immediately. We traded stories, and I told him I hadn't matched. He wanted to be involved," he said. "He helped me with my application and my whole life."

Frame said Meza helped him understand how to learn from his mistakes.

"He said the setback I had (losing a residency slot) doesn't really define who I am or my goals as a person or physician," Frame said. "You have to roll with it and keep moving forward. His kind words helped me get my confidence back."

But one of the biggest pieces of advice Meza gave Frame was to consider a career in family medicine.

"I never had considered it before. I first wanted to become a surgeon and later an emergency medicine physician," he said.

By talking often with Meza, Frame said he learned family medicine has a wide scope of practice.

"I can take care of children, adults and the elderly, as well. That appealed to me because I have always enjoyed working at the free clinic," Frame said.

Good news

Frame's efforts the past year paid off last month with his selection as a family medicine resident by St. Mary's, a 344-bed Catholic hospital owned by Livonia-based Trinity Health.

"I applied to 80 to 90 emergency medicine programs and about 40 family medicine programs in the Midwest, mostly in Michigan, Ohio and Illinois," said Frame, noting that he only applied to 30 hospitals his first go-round.

Frame said he feels very lucky to be selected by St. Mary's, a hospital he described as "excellent" and "offering me lots of opportunities."

Over the next two months before he reports in middle June for orientation, Frame said he will start looking for housing.

"Of all the places I visited, Grand Rapids was the best place," the Detroit-born Frame said. "The downtown is fantastic, and they have put tons on money into the health care infrastructure of the city."

Phil Frame said being in Grand Rapids also will help the family finances as daughter Chelsea, who is a senior at Grand Valley State University in nearby Allendale Township, will live with Nick until she graduates in December. Nick also graduated from Grand Valley.

"It saves us from having to sign a one-year lease on an apartment for her," Phil Frame said. "She gets a roomie she likes and has a lot of experience living with, and Nick gets a roommate who actually likes cooking, doesn't mind doing laundry and is fastidious about cleaning."

Frame said he is very much looking forward to his three years at St. Mary's.

"I know it will be harder than I expected, and I expect to be busy. Right now I am focusing on my job, my program and my education. This is the foundation that will carry me through for the rest of my life. I am just trying to make the most of it."

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